Andrew Jee Soo Kim (NPI# 1053670133, PAC ID# 4688810492) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is HOSPITALIST.
| Nation Provider ID (NPI) | 1053670133 |
| PAC ID by PECOS | 4688810492 |
| Professional Enrollment ID | I20171228000432 |
| Full Name | Andrew Jee Soo Kim |
| Organization Legal Name | ETHNE HEALTH |
| Address |
887 N Indian Creek Dr Suite A Clarkston GA 30021-2247 |
| Phone Number | 4042639334 |
| Gender | M |
| Medical School | STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER |
| Graduation Year | 2012 |
| Primary Specialty | HOSPITALIST |
| Secondary Specialties | FAMILY MEDICINE |
| Group Practice PAC ID | 5092054940 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110076 | DEKALB MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1776 Old Spring House Ln, Atlanta, GA 30338-6225 | 7704540091 | EMORY MEDICAL GROUP, LLC |
| 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 | 4042639334 | ETHNE HEALTH |
| 2701 N Decatur Rd, Decatur, GA 30033-5918 | 4045011000 | EMORY MEDICAL GROUP, LLC |
| Organization Legal Name | ETHNE HEALTH |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean R Lindsey | Hospitalist | Ethne Health | 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 |
| Esther Ern-pei Kim | Family Medicine | Ethne Health | 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 |
| Robert William Contino | Internal Medicine | Ethne Health | 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 |
| Street Address |
887 N INDIAN CREEK DR SUITE A |
| City | CLARKSTON |
| State | GA |
| Zip | 30021-2247 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean R Lindsey | Hospitalist | Ethne Health | 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 |
| Esther Ern-pei Kim | Family Medicine | Ethne Health | 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 |
| Robert William Contino | Internal Medicine | Ethne Health | 887 N Indian Creek Dr, Suite A, Clarkston, GA 30021-2247 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tia L Thomas | Clinical Social Worker | 945 N Indian Creek Dr, Clarkston, GA 30021-2221 | |
| Joyce R Lewis | Family Medicine | Greater Atlanta Family Healthcare LLC | 3700 Market St C, Clarkston, GA 30021-2652 |
| Dorothy Akosua Ofeibea White-williams | Family Medicine | Greater Atlanta Family Healthcare LLC | 3700 Market St C, Clarkston, GA 30021-2652 |
| City | CLARKSTON |
| Zip Code | 30021 |
| Specialty | HOSPITALIST |
| City + Specialty | CLARKSTON + HOSPITALIST |
Please comment or provide details below to improve the information on Andrew Jee Soo Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.